July 15, 2015

Smallpox: Vaccination not Quarantine

By Natasha Hollenbach, Montana Digital Newspaper Project AssistantOn Nov. 25, 1909, The Whitefish Pilot
(below right) ran the headline “Quarantine Abolished.”Further reading reveals that beginning January 1, 1910, people with
smallpox were no longer to be confined to their homes or the ‘pest house’ (a
term used for an isolation house where contagious patients were sent to contain
the outbreak).While these individuals
were still prohibited from public transit, this change in regulations defied the
long established procedure of isolation and containment.The motivation for this change seems to have
been to encourage vaccination.

Although the first vaccination for
smallpox was created in the 1790s, smallpox outbreaks remained common.Outbreaks in Butte (1883), Missoula (1885),
Anaconda (1893), Great Falls (1899) and Missoula & Butte (1900) showed that
the problem was real and needed to be met with consistent, coordinated
action.Disease doesn’t stop at city or
county lines, and neither should the response.In addition, some authority was required to issue the sometimes
unpopular orders to ensure a quick, effective response.

In 1901, the Montana State Board of
Health was created, and one of their first acts was to require children to be
vaccinated before attending school.Smallpox
outbreaks continued, though the number of infected children plummeted.From January through March 1905, there was an
outbreak in Billings.Although Billings
officials were praised for their quick reaction, one-hundred fifty-eight cases
were reported, of whom 16 died.By mid-March,
discussion of the epidemic in the Billings Herald revolved around money,
for good reason, since it reportedly cost Billings over $25,000. During the Billings outbreak, officials
took several measures.Everyone exposed
was vaccinated.Those who were showing
symptoms went to the pest house, and those who didn’t were sent to a detention
house for observation.Every physician
in town was employed by the city to either care for patients or to form
diagnosing squads who investigated possible new cases.The police force was enlarged to enforce the
quarantine.Vaccinations were wide
spread: in a town of about 6,000 over 4,500 tubes of vaccine were purchased,
and presumably used, during the month of January.

There was of course opposition to these
measures.Objections had two main
threads: costs and the perceived violation of personal liberty.The issue of cost had been debated for years.Although most people either didn’t know, or
didn’t believe, it actually cost taxpayers significantly less to provide free
vaccinations than it did to treat those infected.Those who objected for personal liberty
reasons were generally “anti-vaccinationists” who didn’t believe in the
effectiveness of vaccinations.However,
in February 1905 the Supreme Court case of Jacobson v. Massachusetts supported
mandatory smallpox vaccination programs in order to protect public health.

Following the outbreak, T.D. Tuttle,
Secretary of the Montana State Board of Health, wrote a circular entitled “Small
Pox, Its Prevention, Restriction and Suppression.”In it, he emphasizes the importance of
vaccination and promotes the same reasoning used in the 1909 Whitefish newspaper article.

“It is the firm belief of the author that the most effectual way to rid this country of small-pox would be to give a few months warning, in order that all might have time to be successfully vaccinated, and then let any cases of small-pox that might appear go at large, without disinfection, so that those who would not be vaccinated might have the disease and be done with it. Such a move would result in a radical “change of heart” on the part of many, if not all, “anti-vaccinationists.”

In 1909, Tuttle’s recommendations were
enacted.However, while quarantines were
no longer required, local and county boards of health still had the authority
to declare quarantines within their jurisdiction, which lead to some cities,
like Missoula, continuing to use quarantines.The River Press of Fort Benton, on March 15, 1911, reported that there had only been two deaths from smallpox during the previous year, which shows that whichever way
the local boards decided, smallpox seemed to be under control.

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Sources:

Billings
Gazette, March 10, 1905, March 21,
1905, March 24, 1905, and October 31, 1905.